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But if it makes you feel more comfortable, ask your Mom if you can take care of the bills for her, it would be one less thing for her to worry about. Thus you gather up all the past bills, the current bills, the checkbooks, etc. and take them home with you. Ask your parents if you can change the address over to your address so the bills come directly to you. You can have either parent sign the checks when the bills come in if you want, or have your parents go to the bank to add your name "or Jane Smith" so that you can sign the checks yourself. Chances are you will eventually be doing this down the road, why not start now.
My Mom wouldn't listen, either.... I remember back when my Dad had a heart attack, my Mom refused for him to go to a rehab center after his hospitalization, Mom told everyone she could take care of her husband.... well HELLO, Mom was in her early 90's, what was she thinking or was she thinking? Poor Dad had to sleep in his recliner because his legs were like rubber and no way he could go upstairs to the bedrooms... so Mom slept on the living room sofa until Dad got stronger. Poor Dad, lot of sniping and snarling going on because Mom was in denial that he wasn't able to do certain things until he got stronger.
And yes, the financial aspect. My parents saved big time for rainy days, and it was dark clouds overhead but Mom refused to hire any help. It was her generation where it was "her job" to take care of the house and take care of her husband.
I would then discuss it with your mom and explain that it's not fair to either of them to continue that way. I'd see if it would help to have someone come in to help, but it's really not feasible to expect that one senior, would be able to properly provide care for an incontinent, dementia patient with severe mobility issues around the clock. Maybe, a professional, like his doctor could help explain that to her and then recommend some options.
At any rate, I'm not sure how good your communication is, but I would let her know that I wouldn't let it lye. That situation is extremely risky for both parties and that we would work on it together for a better solution. I would consult my own attorney to see what evidence that I needed to file report with authorities, if that was the last resort, but based on what you have seen, it sounds like they really do need help.
1. Falling - fall proof the house as much as you possibly can, with the installation (by a professional carpenter) of grab bars in the bathroom, along walls and other places as needed. Remove throw rugs and other trip hazards. Try to position soft furniture along his travel routes so if he does fall, he might be able to cushion the fall on softer furniture.
2. If you're familiar with their finances, address the payment for care situation yourself - determine if they can afford AL, but also investigate a higher level of care for your father that might involve Medicaid.
3. If you're proxy under a legal or medical POA, ask one of his doctors to script for home care. He could get PT, OT and a visiting nurse, albeit for a limited amount of time. Still, it would help his balance and medical conditions to be monitored, and avoid the more discomforting and challenging effort of going to a doctor (especially as heat waves ravage the nation).
4. I'm guessing your mother is too overwhelmed to step back and make an impartial judgment. Are there any tasks that can be hired out, or any family to help through a transition period?
5. If this is a second marriage, are the adult children from your parent's respective first marriages involved? Can you get together with them, by phone or in person, to address the situation and ask for their help and support in identifying a safer course of action than the current situation?
As with many posts similar to yours, the issue isn't so much whether extra support is needed, it's rather how to get it and pay for it as well as how to convince the elders they need help.